Job Description
Job DescriptionBenefits:
- 401(k)
- 401(k) matching
- Company parties
- Dental insurance
- Free food & snacks
- Health insurance
- Paid time off
- Parental leave
- Savings bank
- Training & development
- Vision insurance
- Wellness resources
About the Role:
Join MedPOINT Management as an Outpatient UM Coordinator in Sherman Oaks, CA, where you'll play a crucial role in ensuring the quality and efficiency of outpatient care. This position offers a dynamic environment where you can make a real impact on patient outcomes and collaborate with a passionate team.
Responsibilities:
- Review and assess outpatient treatment plans for medical necessity and compliance.
- Coordinate with healthcare providers to facilitate timely authorizations and care transitions.
- Utilize clinical guidelines and criteria to determine appropriate levels of care.
- Document and track authorization requests and outcomes in the system.
- Communicate effectively with patients, providers, and insurance companies.
- Participate in interdisciplinary meetings to discuss patient care and service improvements.
- Monitor and report on trends in outpatient utilization and quality metrics.
- Stay updated on regulatory changes and best practices in utilization management.
Requirements:
- Active RN license or relevant clinical certification required.
- Minimum of 2 years of experience in outpatient utilization management or related field.
- Strong knowledge of medical terminology, insurance processes, and clinical guidelines.
- Excellent communication and interpersonal skills to collaborate with diverse teams.
- Proficient in electronic health record (EHR) systems and Microsoft Office Suite.
- Detail-oriented with strong organizational and time-management skills.
- Ability to work independently and manage multiple priorities effectively.
- Commitment to patient-centered care and continuous improvement.
About Us:
MedPOINT Management has been a trusted partner in healthcare management for over 15 years, dedicated to optimizing patient care and operational efficiency. Our clients appreciate our commitment to quality, while our employees thrive in a supportive and innovative work environment that values professional growth and collaboration.
Flexible work from home options available.